Ventilator-Dependent Patients Successfully Weaned With Cognitive-Behavioral Therapy: A Case Series

Cohen, Jonah N.; Gopal, Arun; Roberts, Karsten J; Anderson, Eleanor; Siegel, Andrew M.

doi:10.1016/j.psym.2019.02.003

Cited by 13 publications

(5 citation statements)

References 18 publications

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“…Because the fear of dying by suffocation is so common in ALS patients, this issue asks for active psychological treatment. The positive effects of (mediative) behavioral therapy for ventilator-dependent patients were earlier described by Cohen and colleagues (Cohen et al, 2019). In this form of therapy, anxiety is reduced by means of cognitive and behavioral strategies aiming to reduce the fear of suffocation, often helped by care staff in supporting the patient.…”

Section: Introductionmentioning

confidence: 84%

Eye movement desensitization and reprocessing (EMDR) and mediative behavioral therapy for the treatment of suffocation related post-traumatic stress disorder (PTSD) in amyotrophic lateral sclerosis (ALS): A case report

Oudman

Baert²

2022

Pall Supp Care

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Objective Eye movement desensitization and reprocessing (EMDR) is an established treatment for post-traumatic stress disorders (PTSD). Some patients diagnosed with amyotrophic lateral sclerosis (ALS) experience PTSD following choking or suffocation in the course of progressive loss of the ability to breathe. Although a loss of breathing functions in ALS is relatively common, there are currently no studies available on treatment for the fear of choking following advanced ALS. Methods In this case study, we describe the positive effects of EMDR, an evidence-based form of trauma therapy, in a 48-year-old female, suffering from advanced ALS. As the consequence of ALS, she was not able to speak or breath independently, but could communicate through a speech-generating device. She experienced panic attacks, flashbacks, nightmares, and severe anxiety after her tracheostomy jammed, and she almost suffocated. Results Mediative treatment was started by instructing the care staff to respond neutrally with step-by-step instructions following tracheostomy jam, resulting in significantly less panic attacks and flashbacks. EMDR was initiated two weeks later, and resulted in full remittance of the trauma symptomatology. Significance of the results The present case study suggests that symptoms of PTSD, namely the strong fear of suffocation, can be successfully treated by means of mediative behavioral therapy combined with EMDR.

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Section: Introductionmentioning

confidence: 84%

Eye movement desensitization and reprocessing (EMDR) and mediative behavioral therapy for the treatment of suffocation related post-traumatic stress disorder (PTSD) in amyotrophic lateral sclerosis (ALS): A case report

Oudman

Baert²

2022

Pall Supp Care

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“…Similarly, cognitive-behavioural models can be applied to address psychological barriers to respiratory weaning, particularly when anxiety is maintained by appraisals regarding the meaning of unpleasant yet benign symptoms of weaning. 17 Formulation is key to understanding whether a physiological sensation is triggering distress due to misattribution, association with a trauma memory, discomfort or another cause.…”

Section: Direct Inpatient Interventionsmentioning

confidence: 99%

Key elements of an evidence-based clinical psychology service within adult critical care

Beadman

2021

Journal of the Intensive Care Society

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The COVID-19 pandemic has generated renewed interest in the psychological rehabilitation needs of patients admitted to intensive care units. While the availability of embedded practitioner psychologists within adult critical care teams remains inconsistent, post numbers have increased in response to the clinical needs of the pandemic. As psychology services within adult critical care become more widely established, models for service provision will be required. We describe our experience of developing a model for the delivery of a clinical psychology service within critical care in a District General Hospital with specialist tertiary surgical and cancer services. The current paper describes a service design that is firmly rooted in psychological theory and the broader clinical health psychology evidence base. We hope that our learning will be helpful to others.

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“…However, the psychological interventions used were not defined and cannot be readily replicated in other centers [15]. Second, two case studies suggest that cognitive behavioral therapy (CBT)-informed treatments conducted by a psychologist can expedite liberation from mechanical ventilation [16]. Third, a pilot randomized-controlled trial (RCT) of a CBT-informed protocol, administered by psychologists on a burn unit, reported that survivors (n = 50) had significantly reduced anxiety symptoms and post-traumatic stress disorder (PTSD) at 1 month follow-up [17].…”

Section: Introductionmentioning

confidence: 99%

A Cognitive Behavioral Therapy-Informed Self-Management Program for Acute Respiratory Failure Survivors: A Feasibility Study

Hosey

Wegener

Hinkle

2021

JCM

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Background: The number of people surviving critical illness is rising rapidly around the globe. Survivorship comes at a cost, with approximately half of patients with acute respiratory failure (ARF) experiencing clinically significant symptoms of anxiety, and 32–40% of survivors having substantial anxiety symptoms in the months or years after hospitalization. Methods: This feasibility study reports on 11 consecutive ARF patients receiving up to six sessions of a psychological intervention for self-management of anxiety. Results: All 11 patients accepted and received the psychological intervention. Four patients did not fully complete all 6 sessions due to death (n = 1, 2 sessions completed), and early hospital discharge (n = 3, patients completed 2, 3 and 5 sessions). The median (IQR) score (range: 0–100; minimal clinically important difference: 13) for the Visual Analog Scale-Anxiety (VAS-A) pre-intervention was 70 (57, 75) points. During the intervention, all 11 patients had a decrease in VAS-A, with a median (IQR) decrease of 44 (19, 48) points. Conclusions: This self-management intervention appears acceptable and feasible to implement among ARF patients during and after an ICU stay.

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Ventilator-Dependent Patients Successfully Weaned With Cognitive-Behavioral Therapy: A Case Series

Cited by 13 publications

References 18 publications

Eye movement desensitization and reprocessing (EMDR) and mediative behavioral therapy for the treatment of suffocation related post-traumatic stress disorder (PTSD) in amyotrophic lateral sclerosis (ALS): A case report

Eye movement desensitization and reprocessing (EMDR) and mediative behavioral therapy for the treatment of suffocation related post-traumatic stress disorder (PTSD) in amyotrophic lateral sclerosis (ALS): A case report

Key elements of an evidence-based clinical psychology service within adult critical care

A Cognitive Behavioral Therapy-Informed Self-Management Program for Acute Respiratory Failure Survivors: A Feasibility Study

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